Payroll Action Request Rate or Title Changes for Student Employees, please download and complete this form before making an action request. For questions regarding this form, contact the CEHD Business Office. Requester's Name* Requester's Email* Supervisor's Name* Supervisor's Email* Cannot be the same as requester.Action for:* New Hire Student Employee Staff Terminate Change to existing employee Is student evaluation on file?* Yes No Upload Student Evaluation Drop files here or Select files Accepted file types: pdf, doc, docx, Max. file size: 50 MB. What changes should be made?*(rate of pay, source of funds, annual term, etc.)Employee InformationEmployee Name First Last Title (Optional) UIN or SSN* Email* Start Date* MM slash DD slash YYYY End Date* MM slash DD slash YYYY Percent Effort*Please enter a number from 1 to 100.Rate of Pay*Attach a Document Drop files here or Select files Accepted file types: pdf, doc, docx, Max. file size: 50 MB. NameThis field is for validation purposes and should be left unchanged.